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Frequently Asked Questions

What is the group size criteria for Continuation and COBRA? When are premiums due? Up to what age are dependent children eligible? Can I subtract the premium from a terminated employee from my group premium due amount shown on my statement if the member has terminated? Does CHA Health notify employees of their COBRA or Continuation rights? How can I change my group's waiting period? How can a member check the status of a claim? What if a doctor's office is closed and a member cannot reach the doctor by telephone? Can the member see another PCP in their area? Does a member need a referral to see a specialist? What if a member is away from home and needs to see a doctor? What is the group size criteria for Continuation and COBRA? COBRA applies to groups with twenty (20) or more employees. Continuation applies to groups not eligible for COBRA. back to top When are premiums due? The first (1st) day of the month, for that month's coverage. back to top Up to what age are dependent children eligible? Through age nineteen (19) up to age twenty-five (25) if the child(ren) are full time students. Student verification is required prior to each semester. back to top Can I subtract the premium from a terminated employee from my group premium due amount shown on my statement if the member has terminated? CHA Health will correct all terminations on the next billing statement and give the group credit. back to top Does CHA Health notify employees of their COBRA or Continuation rights? Not for COBRA. CHA Health is responsible for notification and administering eighteen (18) month continuation coverage. back to top How can I change my group's waiting period? Send a letter, on company letterhead, to CHA Health. The change will be effective the first of the following month in which we receive the letter. back to top How can a member check the status of a claim? Members can access myCHAinfo on our web site or call our Member Service Department at 800-457-5683. back to top What if a doctor's office is closed and a member cannot reach the doctor by telephone? Can the member see another PCP in their area? Yes, as long as the doctor is participating with CHA Health and the visit is not for preventative services. back to top Does a member need a referral to see a specialist? CHA Health does not require referral authorization or notification. In the rare occasion that treatment for the member's condition is not available in the CHA Health Prime Network, CHA Health will arrange for the member's care from a non-participating provider. In that case, the member's HMO benefits will apply for the service. back to top What if a member is away from home and needs to see a doctor? CHA Health plans cover urgent and emergency care when you are traveling. If it is an emergency, go to the nearest medical facility. If you need urgent care, go to a facility providing urgent care or to a physician's office. If you have any questions about what you should do, call the CHA Health Nurse Help Line. The phone number is located on the back of your identification card. Registered Nurses are available twenty-four (24) hour s a day, seven (7) days a week to answer your health questions. In addition, your plan may include Assist America benefits available when you are 100 miles from home. back to top